scholarly journals Deaf LGBTQ patients’ disclosure of sexual orientation and gender identity to health care providers.

2019 ◽  
Vol 6 (2) ◽  
pp. 194-203 ◽  
Author(s):  
Cara A. Miller ◽  
Andrew Biskupiak ◽  
Poorna Kushalnagar
Keyword(s):  
Health Care ◽  
Sexual Orientation ◽  
Gender Identity ◽  
Health Care Providers ◽  
Care Providers ◽  
Disclosure Of Sexual Orientation ◽  
And Gender

scholarly journals The role of country-level structural stigma on sexual orientation disclosure and discrimination in health care settings among lesbian, gay, and bisexuals across Europe

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
R Bränström ◽  
J E Pachankis
Keyword(s):  
Health Care ◽  
Sexual Orientation ◽  
Health Care Providers ◽  
Sexual Minority ◽  
Sexual Minorities ◽  
Care Providers ◽  
Health Care Settings ◽  
Country Level ◽  
Disclosure Of Sexual Orientation ◽  
Sexual Orientation Disclosure

Abstract Background The national climate surrounding sexual minorities (i.e., those self-identifying as lesbian, gay, or bisexual [LGB]) varies greatly worldwide. Recent Cross-European studies have shown that country-level structural stigma is a strong determinant of sexual minority individuals health risk behaviors and mental health. The consequences of the significant country-level variation in structural stigma on sexual minorities’ experiences of health care discrimination and disclosure of sexual orientation to health care providers have not been previously investigated. Methods In 2012, 86 000 sexual minority individuals (aged 18 years and older) from all 28 European Union countries responded to questions concerning discrimination in health care settings and sexual orientation disclosure to health care providers (EU LGBT survey). Structural stigma was assessed using a combination of national laws and policies affecting sexual minorities and a measure of sexual minority acceptance among citizens of each country. Results Disclosure of sexual orientation to health care providers were much more common in low stigma coutries (e.g., the Netherlands, Sweden, UK) compared to high stigma coutries (e.g., Lithuania, Latvia, Slovakia). Experiences of discrimination in health care settings were more common among LGB indiviudals who were open about their sexual orientaiton and increased by degree of country-level structural stigma. Conclusions Disclosure of sexual orientation and experiences of discrimination in health care settings varies greatly among LGB individuals in Europe largely due to structural stigma surrounding sexual minorities. Main messages These findings highlight the importance of eliminating legislation, policies, and national attitudes that promote the unequal treatment of sexual minorities in currently unsupportive European countries.

scholarly journals Patients’ Perspectives and Advice on How to Discuss Sexual Orientation, Gender Identity, and Sexual Health in Oncology Clinics

2020 ◽  
Vol 37 (12) ◽  
pp. 1053-1061
Author(s):  
Elizabeth Cathcart-Rake ◽  
Jennifer O’Connor ◽  
Jennifer L. Ridgeway ◽  
Carmen Radecki Breitkopf ◽  
Judith S. Kaur ◽  
...  
Keyword(s):  
Health Care ◽  
Sexual Orientation ◽  
Gender Identity ◽  
Sexual Health ◽  
Health Care Provider ◽  
Health Care Providers ◽  
Care Provider ◽  
Care Providers ◽  
Female Doctor ◽  
Transition Clinic

Objective: This study sought to understand the patients’ perspective of what contributes to an absence of discussions of sexual orientation (SO), gender identity (GI), and sexual health in cancer care. Methods: Patients were recruited from oncology, gynecology, and a gender transition clinic to participate in semistructured interviews, which were analyzed with qualitative methods. Results: A total of 25 patients were interviewed, shedding light on 2 themes. The first was that these conversations are important but infrequent. One patient explained, “…. we know people who have had sex changes…[they] would have appreciated that question.” In response to whether sexual health was ever brought up, one patient responded, “No doctor ever has.” Patients described unaddressed issues: “There have been times, you know, we’ve wondered if it was okay to make love.” The second theme consisted of 4 pragmatic, patient-provided points to facilitate discussions: (1) implementation of a scale of 1 to 10 (with 10 being comfortable) to first gauge patients’ comfort in talking about SO, GI, and sexual health; (2) having the health-care provider explore the topic again over-time; (3) making sure the health-care provider is comfortable, as such comfort appears to enhance the patient’s comfort (“I have a doctor here, a female doctor, who just matter of fact will ask if I get erections and so on because of the medication she’s giving me);” and (4) eliminating euphemisms (one patient stated, “I don’t know what you mean by ‘sexual health’.”). Conclusion: Oncology health-care providers have a unique opportunity and responsibility to address SO, GI, and sexual health.

scholarly journals Encouraging patients to disclose their lesbian, gay, bisexual, or transgender (LGBT) status: oncology health care providers’ perspectives

2018 ◽  
Vol 10 (4) ◽  
pp. 918-927 ◽  
Author(s):  
Smita C Banerjee ◽  
Jessica M Staley ◽  
Koshy Alexander ◽  
Chasity B Walters ◽  
Patricia A Parker
Keyword(s):  
Health Care ◽  
Sexual Orientation ◽  
Gender Identity ◽  
Health Care Providers ◽  
Care Delivery ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Care Providers ◽  
Health Care Environment ◽  
Cross Sectional Survey

Abstract A compelling touted strategy for reducing discrimination towards lesbian, gay, bisexual, and transgender (LGBT) patients is improving communicative competence of health care providers (HCPs); however, evidence base for describing communication practices between HCPs and LGBT patients is scarce. The purpose of this study was to qualitatively examine HCP experiences and perspectives as they relate to patient sexual orientation and gender identity (SOGI) disclosure, perceived communication and structural/administrative challenges in interactions with LGBT patients, and suggestions for improving care of LGBT patients. The sample consisted of 1,253 HCPs, who provided open-ended responses to an online cross-sectional survey conducted at a Comprehensive Cancer Center in the Northeastern United States. The open-ended responses were inductively and deductively coded for key themes and sub-themes. The results demonstrated an array of useful communication strategies employed by oncology HCPs to encourage LGBT patients’ SOGI disclosure (direct questions regarding sexual orientation, use of the term “partner,” and using correct pronouns), communication and structural/administrative challenges faced by HCPs in providing care (HCP own fears and biases, transgender patient care, insurance issues, and procedural challenges for LGBT patients), and suggested recommendations from oncology HCPs to improve their care delivery for LGBT patients (more provider-based training, improving awareness of LGBT-friendly resources, establishing trusting relationships, and not assuming sexuality or gender identity). These findings have implications for developing and evaluating training programs to improve LGBT sensitivity and communication among HCPs, and encourage SOGI disclosure in an open and judgment-free health care environment.

scholarly journals Querying Patients With Cancer About Sexual Health and Sexual and Gender Minority Status: A Qualitative Study of Health-Care Providers

2019 ◽  
Vol 37 (6) ◽  
pp. 418-423 ◽  
Author(s):  
Elizabeth Cathcart-Rake ◽  
Jennifer M. O’Connor ◽  
Jennifer L. Ridgeway ◽  
Carmen Radecki Breitkopf ◽  
Lois J. Mc Guire ◽  
...  
Keyword(s):  
Health Care ◽  
Sexual Health ◽  
Health Care Providers ◽  
Minority Status ◽  
Care Providers ◽  
Gender Minority ◽  
Patients With Cancer ◽  
National Organizations ◽  
Sexual And Gender Minority ◽  
And Gender

Background: Although national organizations advocate that health-care providers ask patients about sexual health and sexual and gender minority status—to learn, for example, about side effects of treatment and to understand patients’ social support—these conversations often do not occur. This study explored health-care providers’ reasons for having/not having these conversations. Methods: This single-institution study recruited health-care providers from medical oncology, hematology, radiation oncology, and gynecology. Face-to-face interviews were recorded, transcribed, and analyzed qualitatively. Results: Three main themes emerged: (1) patient-centric reasons for discussing/not discussing sexual health and sexual and gender minority status (“So I think just the holistic viewpoint is important”); (2) health-care provider–centric reasons for discussing/not discussing these issues (“That’s going to take more time to talk about and to deal with…” or “I was raised orthodox, so this is not something we talk about…”; and (3) reasons that appeared to straddle both of the above themes (eg, acknowledgment of the sometimes taboo nature of these topics). Conclusion: Although many health-care providers favor talking with patients with cancer about sexual health and sexual and gender minority status, limited time, personal reluctance, and the taboo nature of these topics appear at times to hamper the initiation of these conversations.

The role of oncologic health care providers in end of life discussions for women with recurrent gynecologic or breast cancer.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e20543-e20543
Author(s):  
Ashley Stuckey ◽  
Katina Robison ◽  
Don S. Dizon ◽  
Michelle Rogers ◽  
Miles Ott ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Health Care ◽  
End Of Life ◽  
Health Care Providers ◽  
Institutional Review Boards ◽  
Care Providers ◽  
Provider Type ◽  
Health Care Proxy ◽  
Recurrent Cancer ◽  
And Gender

e20543 Background: Advance care planning (ACP) is an important topic for women with metastatic or recurrent cancer. Unfortunately, data suggest ACP is often not discussed at health care visits. Because patients with metastatic or recurrent cancer are incurable, the issue of end of life (EOL) is one faced by patients and providers. This study evaluates how often oncologic health care providers initiate EOL conversations with their patients. Methods: Eligible patients included women with metastatic or recurrent gynecologic or breast cancer of ≥3 month’s duration in an academic women’s oncology program. Interviews were conducted by research staff. Clinical characteristics and documentation of EOL decisions were obtained through chart reviews. Data were analyzed using SAS v.9.3. Multivariate logistic regression was used to model the association of EOL discussions with ACP. The study was approved by the hospital and university Institutional Review Boards. Results: 200 women were enrolled; 64% had stage III-IV cancer at diagnosis. The majority was white (91%) with a mean age of 60 (range 35-82). A total of 638 providers were identified (mean: 3.2 providers per patient; 57% female). Health care provider type and gender were not associated with EOL discussions. Only 49 women (25%) recalled an EOL conversation with at least one provider which appeared to correspond to the low proportion of people with documented ACP. Only 42 (22%) had an advanced directive (AD) and 29 (15%) a health care proxy (HCP) in the chart. Having an EOL conversation with at least one provider was not associated with a chart-documented AD (OR=1.6, 95% CI=0.7-3.6) or HCP (OR=1.8, 95% CI=0.7-4.5). The time since recurrence was shorter for those reporting EOL conversations (1.7 vs. 3.1 years, p=.0274). Conclusions: In this study, oncologic health care providers infrequently initiated EOL discussions with their patients with metastatic or recurrent cancer. More concerning, patient recollection of an EOL discussion with a provider was not associated with chart-documented ACP. Further studies evaluating the factors limiting EOL discussions as well as studies testing interventions to improve provider documentation of the ACP are warranted.

Breaking down barriers: A strategic initiative to collect sexual orientation and gender identity information in the oncology patient population.

2020 ◽  
Vol 38 (29_suppl) ◽  
pp. 128-128
Author(s):  
Georgina T. Rodgers ◽  
Christa Poole ◽  
MaryKay Moore ◽  
Mikayla Baer ◽  
Christina Ferraro ◽  
...  
Keyword(s):  
Sexual Orientation ◽  
Gender Identity ◽  
Health Care Providers ◽  
Comfort Level ◽  
Cancer Center ◽  
Care Providers ◽  
Target Groups ◽  
Oncology Patient ◽  
Increased Risk ◽  
The Impact

128 Background: The LGBT community is a diverse population that crosses race, ethnicity, socioeconomic status, age, and other factors. It is estimated that 8.8 million Americans are part of the community and the number is likely higher due to under reporting. The population is at increased risk for certain cancers, sexually transmitted infections, and is more likely to use alcohol, tobacco, drugs, and suffer from obesity, and behavioral health issues. LGBT patients face barriers to accessing care due to being under-insured, fear of discrimination and lack of access to culturally competent health care providers. Our cancer center embraced the need to collect sexual orientation/gender identity (SOGI) data as a means to identify and address the comprehensive needs of our patients and set a goal to provide an inclusive, patient-centered environment through education of our teams to build a trusted patient-provider relationship. Methods: We implemented a history section in the EHR to assist with data collection including, preferred name, sexual orientation, gender identity, legal sex, and sex assigned at birth. A project team was developed in 2019 to improve utilization of the existing tool and provide education to increase the comfort level of our caregivers. Our target groups consist of advance practice providers, RN care coordinators, social workers and physicians. Educational sessions occurred through multiple modes and “champions” were identified within target groups to keep the momentum going. Results: There was initial hesitation in utilization due to lack of understanding of the impact on patient care and lack of confidence in communication. Training was modified to include communication techniques and the why collection of SOGI data is important. Conclusions: A monthly report was developed to determine utilization of the SOGI fields and as of May 2020 have increased from 1.5% utilization to 17.5% utilization. A survey has been deployed to education attendees to determine pre and post education comfort levels in addressing the SOGI needs of patients and early data is showing a marked improvement in the comfort level of caregivers.

scholarly journals Teaching Health-Care Providers to Query Patients With Cancer About Sexual and Gender Minority (SGM) Status and Sexual Health

2019 ◽  
Vol 36 (6) ◽  
pp. 533-537 ◽  
Author(s):  
Elizabeth J. Cathcart-Rake ◽  
Carmen Radecki Breitkopf ◽  
Judith Kaur ◽  
Jennifer O’Connor ◽  
Jennifer L. Ridgeway ◽  
...  
Keyword(s):  
Health Care ◽  
Sexual Health ◽  
End Of Life ◽  
Health Care Providers ◽  
Position Statement ◽  
Care Providers ◽  
Related Data ◽  
Patients With Cancer ◽  
And Gender ◽  
American Society

End of life is difficult for all patients but sexual and gender minorities (SGM) are prone to isolation and loneliness, especially if their SGM status is unknown or unaccepted. In oncology clinics, where goals of care discussions about end of life are integral and frequent, querying patients about their SGM status and sexual health is of particular importance. The American Society of Clinical Oncology recently released a position statement that called for greater focus on SGM populations with the goal of reducing and eventually eliminating disparities in cancer care within this group. An important first step in addressing such disparities is learning how best to train cancer health-care providers to ask patients about their SGM status and about sexual health in general. This article summarizes the mandate for understanding cancer issues in SGM populations and the dearth of cancer-related data within this group. This article also describes an ongoing 3-part study intended to build a mini curriculum with the goal of helping cancer health-care providers to ask patients with cancer about SGM status and to ask all patients with cancer about sexual health issues. The results of this ongoing study could potentially improve end-of-life care for subgroups of patients.

SOGI Training in Catholic Health Care

2019 ◽  
Vol 44 (3) ◽  
pp. 3-4
Author(s):  
Keyword(s):  
Health Care ◽  
Sexual Orientation ◽  
Gender Identity ◽  
Training Programs ◽  
Advocacy Organizations ◽  
Health Care Institutions ◽  
Catholic Health Care ◽  
And Gender ◽  
The Church

In response to activists’ demands and new regulations and guidance, some Catholic health care institutions and systems have begun implementing mandatory sexual orientation and gender identity (SOGI) training programs for employees. The National Catholic Bioethics Center is con- cerned that such programs may be heavily influenced by, or adapted directly from, transgender advocacy organizations. If these programs fail to accurately reflect Catholic teaching, they can undermine the witness of the Church and create conflicts of conscience for many in Catholic health care.

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